What I Know About: The PITA Patient

Thanks, awesome article

I'm a brand-new nurse, still on orientation, and I have come across this type of patient. I realized as I was reading your article that I let the general attitude towards these patients get to me (spend as little time as possible with them, eye-roll the 5th call light in an hour, etc). Thank you for reminding me how I felt towards this kind of patient while I was a student. I'm ashamed that I let my attitude change so significantly in such a short amount of time.

I don't think this should be intended for students and new nurses...everyone needs to read this one!When ever I have a PITA, I try to remember that they are one of the most important people in the world to someone and then I try to treat them like I would want important people in my world treated. I learned a long time ago, that spending twenty minutes (even when I don't think I have twenty minutes) with a patient, might save me hours and hours later. We recently had a patient who is severely disabled (mentally and physically) He is on the call light almost constatnly wanting little things like less ice or more ice or his blanket folded more neatly. He is taking some classes at the local Morman church and he wanted help finding some things in the Book of Morman. I was slammed with ERs, but the other nurse (who is usually mean and grouchy and HATES religion) spent over an hour helping him. Then I spent time coloring with him and found some Bible word searches online and printed them out. The patient was pain free all night and slept for at least a six hour stretch...something he hadn't done for several days. The next three days and nights, the other nurse and I were off and his pain and insomnia were back.

To tag a pt a PITA is to label them by the effect they have on the nurse's time. This is far removed from the place where solutions live. And sometimes there are no real solutions, frequently to the worst of floor problems, like borderline personality disorder.

Well said, Viva. As always.

Thank you for this post. It struck me a little too close to home regarding a patient that I cared for this week.

Definitely a believer that spending an extra few minutes at the beginning of a shift goes a long way. I also found that being straightforward helps. People can tell when you're being fake or trying to feed them a load of bs. The other thing that has been a huge help; especially with the "clock watchers" is telling them that I plan to be back @ xyz time, but to please give me a little wiggle room. I usually tell them that if I'm not back about 10 minutes past the said time to please call me in case I got tied up. I also ask them if they want woken-up for PRN pain meds or if they just want me to leave them be. Then it puts the responsibility/choice back on the patient. Now, do I go wake the pt every time who wants the q2h dilaudid every two hours? No, but if it's been more than three to three and a half hours, I check with him/her.Admittedly, there are some people that there is just no pleasing. Someone mentioned borderlines as an example. Those ones I just do my job, be as straightforward as possible, and let them do what they're going to do anyway. Then I remind myself that the shift is only 12 hours of my life. Also, those patients are the ones we try to rotate. And if the pt asks why, I tell him/her. Nicely, of course, but the message gets across.

I am a new CNA and have had a few patients like this...especially one last night. However I found that a quick silent prayer on my end and a deep breath have helped me deal with these patients. I just try to remember that it's better to be on my side of the bed than theirs.

Thank you for this. I love it when I run accross helpful info that is spun in such a positive way. It keeps me in check, and reminds me why I am here. Love it.

At the risk of sounding foolish, what does PITA mean? I've never heard that term before.

PITA. Somedays I'm so dumb. Just figured out what that is.

LOL. Sometimes I'm a little slow on the uptake. In the early days of the internet, when I would see "LOL" I would think "little old lady," and wonder why people kept referencing them...it made no sense.